Evaluación de Guevara Fernández Juan Antonio

This section will look at how newspapers have reported about the controversial issue of sperm donation, and how this debate evolved dur- ing the 2010's. This analysis will focus on archive searches of the China Daily and Global Times. Both newspapers have news archives that are available online. Before the news of legal proceedings broke out in early 2012, following the death of a sperm donor in Hubei Province, there was only little news coverage of issues involving sperm banks and sperm do- nors. An archive search of the China Daily (CD) between 2001 (when ministerial bodies started to license and regulate human sperm banks and assisted reproduction) and 2011 (when a sperm donor died during the donation process) produces only sparse results. In some years, there were none, and in other years only up to two news articles per year. Reports during this period covered issues like the need of sperm banks for more sperm donors (CD 2004), the difficulties that infertile couples face to find a matching sperm donor (CD 2008), and the burdens and familial pres- sures that childless couples face when trying to conceive (CD 2010a). By 2009, the director of Shanghai’s first sperm bank in an interview with the CD still considered sperm donation to be a social taboo in China (CD 2009), citing cultural prejudices and a lack of knowledge as the main rea- sons to keep potential donors away from enrolling with sperm banks. Medical experts and government officials have always attributed the shortage of donor applications to a ‘lack of education’ and insufficient knowledge about sperm donation among the general population (CD 2012a), yet at the same time the media also did little during these years to change public awareness and attitudes about the issue. Around 2010, this situation slowly started to change. The director of Guangdong Province’s sperm bank for instance stated to the media that the numbers of prospec-

tive donors in 2010 had gone up by almost 100%, compared to the aver- age in previous years, when over 900 applicants attended his sperm bank (CD 2011). According to him, the numbers started to improve, because “more people, especially college students, have developed an interest in donating sperm”.

The majority of sperm donors have always been students in China. A 7-year multicentre retrospective study of sperm donation and its applica- tion in China examined four major sperm banks between 2003 and 2009 and concluded that college students constituted by far the largest occupa- tional group (92.7%), and that only a small percentage of donors were of- fice workers or trade and medical professionals (less than 8%) (Ping et al. 2011). The study further found that the majority of donors were also un- married (95.2%) and childless (99.1%). There is no science behind it, but some like Jiangsu Province’s sperm bank in East China in Nanjing city have altogether stopped accepting applications from working men, out of concerns about the lesser quality of their samples (GT 2012e). For the di- rector of Jiangsu’s sperm bank, this is a result of lifestyle, because “work- ing males are usually under excessive pressure and many have bad habits, including drinking, which negatively affects their sperm”

(GT 2012e)

While about 30% of the sperm donated in this sperm bank does not meet the required standard, the rate is said to be less than 20% in sperm samples from office or so-called white-collar workers (CD 2013c). In con- trast, the rate of all donors (including students and all other groups) pass- ing the examination at the Beijing Human Sperm Bank under the Nation- al Research Institute for Family Planning was said to be about 20% in the same year (GT 2013c).

The gradual change in the attitudes of Chinese men to consider sperm donation coincided with new efforts by sperm banks to increase the number of applicants. These early recruitment campaigns aimed particu- larly at university campuses, and news reporting began to pick this up too (Klein 2017). Recruitment on campuses usually involved students who were former sperm donors themselves, and their role was to distribute leaflets among classmates and in dormitories. Newspapers informed the public for instance that flyers were circulated on Beijing university cam- puses with the message: “if you are over 22 years old, male, healthy, full of love, courage and confidence, you are the right person for us” (GT 2010). It was also documented that these efforts caused a range of differ- ent reactions among students, many of whom were still lacking knowledge and awareness of the culturally sensitive topic. Most had never even talked or read about sperm donation before. A common reaction was therefore to question the purpose and methods of recruitment. One young student for instance said to a journalist: “I saw this in the re- strooms on our campus and even our dormitory, it’s embarrassing” (GT 2010). Hence, this form of recruitment was not always guaranteed to be successful. A student recruiter in Shanghai who was distributing leaflets in his dormitory for instance had not received any feedback from his fel-

low students, and he argued that this was due to their fear ‘to lose face’, in that by becoming a sperm donor they would have less chances of find- ing a girlfriend (GT 2012e). The attitudes and motivations of Chinese men for or against sperm donation also came into focus. Against sperm donation were voices such as: “I can't bear the thought that I might someday meet my offspring, whom I wouldn't even know” (CD 2012a).

There are also those for whom preserving biological kinship was not as much a personal value, as they worried it could affect ‘others’ like their family, friends or partners, and what would happen if they found out. A newspaper also reported about a graduate student in Beijing who had in fact decided to become a sperm donor, but who noted that he had kept the donation a secret out of worry that “my family might kill me for let- ting a stranger use the precious family seed” (CD 2010). Risk of incest through intermarriage of ART conceived descendants from the same do- nor has also been a recurring theme in media interviews with the public. A man from Hubei Province for instance, who over a decade ago when he was a student decided to become a sperm donor, told the media that “it feels weird to know that someone you meet on the street someday could be your child” (GT 2013b). He had decided to donate his sperm out of altruistic reasons, but is now married with his own child and full of re- morse that he may have other kids.

While these cases demonstrate how sperm donation may be perceived as a risk factor for family and social relations, others like a senior student in Beijing also found that recruiting students to become sperm donors is a good thing, because it “reflects progress in society” and allows students “to make a contribution to the quality of the population in the future” (GT 2010). However, flyers and posters as methods of information dis- semination to reach students have not always proven to be effective, and some sperm banks also turned to other strategies for recruitment on cam- puses including for instance collaborations with student unions. For the director of the Guangdong sperm bank, this turned out to work better, as “student union members normally talk to students one-on-one in private about sperm donation” (CD 2011). The director of Shanghai’s sperm bank even appeared on local radio programs and gave lectures at the city's Fudan and Tongji Universities to encourage more students to be- come sperm donors (CD 2012a).

The comparison of sperm donation with blood donation was another common strategy to make the former more acceptable and to overcome deep-rooted sociocultural concerns. In this vein, sperm bank staff explain to potential sperm donors similar to the director in Hubei Province that “just like blood donation, giving sperm is a humanitarian and charitable deed” (GT 2013b). However, in as much as altruism is often presented as the main motivational factor, there is also a monetary dimension to the incentive to become a sperm donor. Although financial payments and the selling of sperm are strictly prohibited for ethical reasons, monetary com- pensation of donors for their time and expenses is permitted and ap-

proved by the provincial authorities (MOH 2003). This is also the case in other countries including the UK10_{. Compensation payments are often}

quite high in China compared to normal living costs and salaries, but medical staff insist that the cash payments are not the same as incentive payments. For instance, the director of Guangdong’s sperm bank defend- ed this system to the media, in that it “doesn’t mean they are selling sperm”, but that the sperm bank is “providing meals and transport fees and compensation for loss of working time” (CD 2011).

Donors are usually given compensation payments as the tests progress to make sure that they return and complete the full process which can be lengthy. Applicants usually first receive small payments to have their blood and semen tested, and they receive greater sums for every ml of sperm they give to the bank. When donors complete the process and re- turn for the final HIV test six months after their last sample was frozen, they receive an additional bonus payment. The full compensation pay- ment in 2011 was slightly above the average monthly income in Shanghai (CD 2011a).

In early 2012, the death of a sperm donor in the city of Wuhan took centre stage in the newspapers. The death of the 35-year old received great media exposure, when the case went to court and the father sued the sperm bank for four million Yuan (US$ 628,972) (GT 2012). Howev- er, the district court ruled in June that the donor, who studied towards a doctoral degree in medicine, was entirely capable of making his own deci- sions about his life, including whether he wanted to take part in the sperm bank program. He had signed up as a sperm donor in January 2011 and within ten days had made his fourth visit to donate sperm, when he collapsed in the collection room. In the aftermath of the tragic incident and the ensuing court case, news reporting about sperm dona- tion increased significantly. For instance, a series of headlines in the Global Times (GT) in the month of September alone read: “Sperm Banks running empty” (GT 2012a), “Sperm bank calls for more donors” (GT 2012b), “Sperm bank offers donors a raise” (GT 2012c), and “Thank you for coming” (GT 2012d). In January 2013, the China Daily published a large editorial on “Banking on sperm – hope for childless couples” with a large collection of articles on related topics, such as an institutional over- view of different sperm banks, what is involved in the process, a frequent- ly asked questions section about sperm donation, and public attitudes about sperm donation (CD 2013).

State censorship of the media with respect to sperm donation has only been visible indirectly, when media reporting aligns with government pol- icies. This is for instance the case when newspaper articles tend to show- case certain motivations and attitudes over others, as the selling of sperm is strictly forbidden in China, and donors are expected to have altruistic motivations (despite the fact that they receive significant financial com- pensations). Donors interviewed by the media are often quoted as being altruistic, and motivational statements such as “I'll just be glad if I can

help a childless couple” (CD 2010) are quite common in the media de- bate. However, although the media may showcase altruistic intentions over other motivations, donors also have personal motivations and indi- vidual experiences that make them inclined to, as Mohr (2014) puts it, “enact their moral selves”. This is certainly the case when for instance a 34-year old civil servant in Shanxi Province described to a journalist that he became a sperm donor when his brother became infertile - in a car ac- cident, and the condition eventually led to his divorce (CD 2013a). The donor firmly believed that the divorce could have been prevented, if his brother and sister-in-law would have known more about sperm donation, and he therefore hoped to help others in a similar situation. Yet, he also hid his donation from his wife, because he was not sure if she would have accepted it. In contrast, however, the newspaper also reported about a young student in Beijing who had openly discussed his wish to become a sperm donor with his girlfriend, who did not agree to it right away, but who eventually convinced her “that it was a worthy cause as it would help couples or single woman who are unable to reproduce get children” (CD 2016). Likewise, a 22-year old university student in Shanxi Province em- phasized in an interview that it was important to him that people do not think that he sold his sperm, even though he was given a considerable amount of money for a student (CD 2013a). He did not want his actual intention to be misrepresented, which was to help infertile couples.

By 2013, public perception of sperm donation had shifted so much that it no longer fitted easily with the old system of Confucian values of filial duty and the patriline. There was now a more knowledgeable and better informed (male) public with a greater openness to sperm donation, and sperm banks significantly changed their tactics of interaction with the male public. Social media became the new favourite platforms of recruit- ment, and the setting up of blogs and accounts on popular Chinese web- sites and phone applications, such as Sina Weibo11 _{and WeChat}12_{, be-}

came popular strategies of sperm banks to reach the young, male public. This way, sperm banks were now able to engage more directly with large numbers of internet users, and to provide those considering sperm dona- tion with the opportunity to ask questions without the need to attend a sperm bank. Hand in hand with the use of social media to promote sperm donation, many provincial authorities also increased the level of monetary compensation to incentivize more men to become sperm donors. The higher compensation figures helped to draw more attention to sperm banks, and this in turn also was picked up frequently by the press. Henan Province’s sperm bank early in this process posted a message on Sina Weibo, in which it offered cash payments of up to 5,000 Yuan (US$ 789) (GT 2013a). After the notice was issued, the sperm bank reported that it received around 50 donations per day and up to 100 during holiday peri- ods, which was a significant increase to the number of applicants that had attended the sperm bank before. Monetary compensation in the range of 4,000 to 5,000 Yuan (US$ 631-789) was already quite high compared to

normal living standards, but Zheijiang’s sperm bank in Hangzhou Prov- ince even topped all other sperm banks, when it posted on its Sina Weibo profile that it would offer a bonus of 6,000 Yuan (US$ 975) (CD 2013b). In the UK, in contrast, where living standards, costs and salaries are much higher, the amount is set at GBP£ 35 per visit (Human Fertilization and Embryology Authority). The principle behind it is that the amount of- fered is not a payment and a person should never feel compelled to do- nate for financial gain but rather because they want to help a family in need. The money a donor receives is to compensate for out of pocket ex- penses. This means that after 12 weekly visits over three months, a donor in the UK receives a total of GBP£ 420, which is far less than what a do- nor receives in China, where living standards and average living costs are much lower.

This quickly led to a race among sperm banks for bolder statements and catchier awards for donors. In 2015, Hubei Province’s sperm bank lured new volunteers with a WeChat message beneath a photo of an iPh- one 6s which read: “5,000 Yuan (US$ 785) will be paid for 40 ml sample of semen (the iPhone 6s is priced at 5,288 Yuan on the mainland)” (CD 2015). The China Daily also reported that the message received 85,000 page views within two weeks and that it was a much talked about topic among students and in online discussion forums. Trying to keep up, Shanghai also increased its compensation level to the maximum of 6,000 yuan and posted a controversial advertisement on WeChat stating to draw attention: “no need to sell a kidney... Shanghai sperm bank can make your iPhone 6s dream come true” (GT 2015). ‘To sell a kidney’ is a well-known metaphor in China that was coined when a 17- year old teen- ager made headlines in 2011 for selling his kidney on the black market to afford an iPhone and iPad. Within only a few days, the post had been viewed over 100,000 times. Although it drew heavy criticism for exploit- ing that case, the post was deemed a success, as the sperm bank was able to increase its rate of 20 phone calls on normal working days to 200-300 calls per day to those selected from registrations on the sperm bank’s website. Online registrations of interest and calling up potentially eligible donors by phone have now also increasingly replaced the traditional walk-in service. In July 2015, online donor recruitment was taken to a new height, when seven sperm banks teamed up with the Chinese e- commerce company Alibaba in a three-day commercial campaign that was launched on the online shopping site ‘Taobao’. Chinese men were promised that by signing up and completing a sperm donation they could receive a payment between 3,000 Yuan (US$ 483) and 5,000 Yuan (CD 2015a). Within the three days that the campaign lasted more than 22,000 signed up to register with a sperm bank. The registrations were passed on to the relevant sperm banks, some of which received equivalents to nearly a year of walk-in traffic.

At a time, when sperm donations just had started to pick up, the CPC in January 2016 implemented the new ‘two-child policy’ in order to curb

down on population aging and to expand the pool of working-age people. As a result of this policy change, sperm banks in Beijing, Shanghai, Shan- xi and Hubei announced that their sperm storage was at an all-times low (GT 2016, South China Morning Post 2016). The end of the country's decades-old family planning policy has put new pressures on sperm banks, as the waiting times for donor sperm have gone up even further. Many families want to take advantage of the reforms to have a second child,